The Origin of the Plastic Surgery??
Many people consider Plastic Surgery as a relatively new specialty, the origin of the plastic surgery had his roots
more
than 4000 years old in India, back to the Indus River Civilization. The
mythico-religious shlokas (hymns) associated with this civilization
were compiled in Sanskrit language between 3000 and 1000 B.C. in the
form of Vedas, the oldest sacred books of the Hindu religion. This era
is referred to as the Vedic period (5000 years B.C) in Indian history
during which the the four Vedas, namely the Rigveda, the Samaveda, the
Yajurveda, and the Atharvaveda were compiled. All the four Vedas are in
the form of shlokas (hymns), verses, incantations and rites in Sanskrit
language.
‘Sushruta Samhita' is believed to be a part of Atharvaveda.
Plastic
Surgery – was first performed in India around 2000 BC and then
popularized in the Arab world that actually launched it to Europe. The
person behind this groundbreaking medical practice in India was
Sushruta. He is credited for performing the first rhinoplasty (nose-job)
with a unique understanding of the circulation system.
Cataract
surgery - Cataract surgery was also known to the him (Indian physician
Sushruta) in 6th century BCE. In India, cataract surgery was performed
with a special tool called the Jabamukhi Salaka, a curved needle used to
loosen the lens and push the cataract out of the field of vision. The
eye would later be soaked with warm butter and then bandaged. Though
this method was successful, Susruta cautioned that cataract surgery
should only be performed when absolutely necessary. Greek philosophers
and scientists traveled to India where these surgeries were performed by
physicians. The removal of cataract by surgery was also introduced into
China from India.
Stones
- The earliest operation for removal of a stone is also given in the
Sushruta Samhita (6th century BCE). The operation involved exposure and
going up through the floor of the bladder.
‘Sushruta
Samhita'(Sushruta's compendium), which describes the ancient tradition
of surgery in Indian medicine is considered as one of the most brilliant
gems in Indian medical literature. This treatise contains detailed
descriptions of teachings and practice of the great ancient surgeon
'Sushruta' which has considerable surgical knowledge of relevance even
today.
Because
of his seminal and numerous contributions to the science and art of
surgery he is also known by the title "Father of Surgery." Much of what
is known about this inventive surgeon is contained in a series of
volumes he authored, which are collectively known as the Sushruta
Samhita in which he describes over 300 surgical procedures and 120
surgical instruments and classifies human surgery in 8 categories. He
lived, taught and practiced his art on the banks of the Ganges in the
area that corresponds to the present day city of Varanasi in North
India.
Medicine & Surgery :
An
artist's impression of an operation being performed in ancient India.
In spite of the absence of anesthesia, complex operations were
performed. The practice of surgery has been recorded in India around 800
B.C. This need not come as a surprise because surgery (Shastrakarma) is
one ofthe eight branches of Ayurveda the ancient Indian system of
medicine. The oldest treatise dealing with surgery is the Shushruta
Samahita (Shushruta's compendium). Shusruta who lived in Kasi was one of
themany Indian medical practitioners who included Atraya and Charaka.
He was one of the first to study the human anatomy. In the Shusruta,
Samahita he has described in detail the study of anatomy withthe aid of a
dead body. Shusruta's forte was rhinoplasty (Plastic surgery)and
ophthalmialogy (ejection of cataracts). Shushruta has described surgery
under eight heads Chedya (excision), Lekhya (scarification),Vedhya
(puncturing), Esya (exploration), Ahrya (extraction), Vsraya
(evacuation) and Sivya (Suturing).
Yoga
is a system of exercise for physical and mental nourishment. The
origins of yoga are shrouded in antiquity and mystery. Since Vedic
times, thousand of years before, the principles and practice of yoga
have crystallized. But, it was only around 200 BC that all the
fundamentals of yoga were collected by Patanjali in his treatise, named
Yogasutra, that is, Yoga-Aphorisms.
In
short, Patanjali surmised that through the practice of yoga, the energy
latent within the human body may be made live and released, which has a
salubrious affect on the body and the mind. Now, in modern times,
clinical practices have established that several ailments, including
hypertension, clinical depression, amnesia, acidity, can be controlled
and managed by yogic practices. The application of yoga in physiotherapy
is also gaining recognition.
Sushruta
has pointed out that haemorrhage can be arrested by apposition of the
cut edges with stitches, application of styptic decoctions, by
cauterisation with chemicals or heat. That the progress of surgery and
its development is closely associated with the great wars of the past is
well known. The vrana or injury, says Sushruta, involves breakdown of
body-components and may have one or more of the following seats for
occurrence, viz., skin, flesh, blood-vessels, sinews, bones, joints,
internal organs of chest and abdomen and vital structures. Classically
vrana, the wound, is the ultimate explosion of the underlying
pathological structure. It is, in Sushruta's words, the sixth stage of a
continuous process, which starts with sotha (inflammation). Sushruta
says that in the first stage, the ulcer is unclean and hence called a
dusta-vrana. By proper management it becomes a clean wound, a
suddha-vrana. Then there is an attempt at healing and is called
ruhyamana-vrana and when the ulcer is completely healed, it is a
rudha-vrana. Sushruta has advocated the use of wine with incense of
cannabis for anaesthesia. Although the use of henbane and of Sammohini
and Sanjivani are reported at a later period, Sushruta was the pioneer
of anaesthesia.
Sushruta
describes eight types of surgical procedures: Excision (chedana) is a
procedure whereby a part or whole of the limb is cut off from the
parent. Incision (bhedana) is made to achieve effective drainage or
exposure of underlying structures to let the content out. Scraping
(lekhana) or scooping is carried out to remove a growth or flesh of an
ulcer, tartar of teeth, etc. the veins, hydrocele and ascitic fluid in
the abdomen are drained by puncturing with special instrument
(vyadhana). The sinuses and cavities with foreign bodies are probed
(esana) for establishing their size, site, number, shape, position,
situation, etc. Sravana (blood-letting) is to be carried out in skin
diseases, vidradhis, localised swelling, etc. in case of accidental
injuries and in intentional incisions, the lips of the wound are apposed
and united by stitching (svana.)
To
obtain proficiency and acquiring skill and speed in these different
types of surgical manipulations, Sushruta had devised various
experimental modules for trying each procedure. For example, incision
and excision are to be practised on vegetables and leather bags filled
with mud of different densities; scraping on hairy skin of animals;
puncturing on the vein of dead animals and lotus stalks; probing on
moth-eaten wood or bamboo; scarification on wooden planks smeared with
beeswax, etc. On the subject of trauma, Sushruta speaks of six varieties
of accidental injuries encompassing almost all parts of the body.
Sushruta
also gives classification of the bones and their reaction to injuries.
varieties of dislocation of joints (sandhimukta) and fractures of the
shaft (kanda-bhagna) are given systematically. He classifies and gives
the details of the six types of dislocations and twelve varieties of
fractures. He gives the principles of fracture treatment, viz.,
traction, manipulation, appositions and stabilisation. Sushruta has
described the entire orthopaedic surgery, including some measures of
rehabilitation, in his work.
As
war was a major cause of injury, the name Salya-tantra for this branch
of medical learning is derived from Salya, the arrow of the enemy, which
in fights used to be lodged in the body of the soldiers. He emphasises
that removal of foreign bodies is fraught with certain complications if
the seat of the Salya be a marma.
Sushruta
also discusses certain surgical conditions of ano-rectal region, he has
given all the methods of management of both haemorrhoids and fistulae.
Different types of incision to remove the fistulous tract as langalaka,
ardhalangalaka, sarvabhadra, candraadha (curved) and kharjurapatraka
(serrated) are described for adoption according to the type of fistula.
Sushruta
was well aware of the urinary stones, their varieties; the anatomy of
urinary bladder along with its relations is well recorded in the chapter
on urinary stones. Varieties of stones, their signs and symptoms, the
method of extraction and operative complication are given in detail.
Apart from the above, surgery of intestinal obstruction
(baddha-gudodara), perforated intestines (chidrodara), accidental
injuries to abdomen (assaya-bhinna) in which protrusion of omentum
occurs are also described along with their management.
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